Fundus observation apparatus

ABSTRACT

A fundus observation apparatus that is capable of assisting an examiner in judging the presence or absence of abnormality in an examinee&#39;s eye based on a fundus tomographic image. The fundus observation apparatus includes an optical coherence tomography device that has an optical scanner for setting an image pickup position on a fundus of an examinee&#39;s eye, and is arranged to obtain a tomographic image of the fundus, and an information display unit that is arranged to display on a monitor the tomographic image obtained by the optical coherence tomography device and assisting information for assisting an examiner in performing judgment on the tomographic image, and the information display unit is arranged to change the assisting information based on image pickup information on the tomographic image.

This is a Reissue of U.S. Pat. No. 8,419,186, issued Apr. 16, 2013,which issued from U.S. application Ser. No. 12/894,551, filed Sep. 30,2010, which claims the benefit of Japanese Patent Application No.2009-228768, Sep. 30, 2009.

More than one reissue application has been filed for the reissue of U.S.Pat. No. 8,419,186. The reissue applications are application Ser. No.14/681,680 (the present application), and application Ser. No.15/262,708, which is a Reissue Divisional of the present application.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to a fundus observation apparatus thatobserves a tomographic image of a fundus of an examinee's eye.

2. Description of Related Art

Conventionally, a fundus observation apparatus that obtains atomographic image of a fundus of an examinee's eye using an opticalinterference technique (i.e., an optical coherence tomography apparatus)is used for evaluating the condition of the examinee's eye (see JapanesePatent Application Laid-open Publication No. 2005-29467). This kind offundus observation apparatus controls a monitor to display a fundusimage picked up by using infrared light. An examiner selects a givenregion (portion) of the fundus image and obtains a fundus tomographicimage of the selected region. The examiner observes the obtained fundustomographic image and judges the presence or absence of abnormality inthe examinee's eye.

However, a great deal of expertise is required for judging the presenceor absence of abnormality in the examinee's eye based on the fundustomographic image because the fundus tomographic configuration variesdepending on the selected region of the fundus image.

SUMMARY OF THE INVENTION

An object of the invention is to overcome the problems described aboveand to provide a fundus observation apparatus that is capable ofassisting an examiner in judging the presence or absence of abnormalityin an examinee's eye based on a fundus tomographic image.

To achieve the objects and in accordance with the purpose of the presentinvention, a fundus observation apparatus has an optical coherencetomography device that has an optical scanner for setting an imagepickup position on a fundus of an examinee's eye, and is arranged toobtain a tomographic image of the fundus, and an information displayunit that is arranged to display on a monitor the tomographic imageobtained by the optical coherence tomography device and assistinginformation for assisting an examiner in performing judgment on thetomographic image, and the information display unit is arranged tochange the assisting information based on image pickup information onthe tomographic image.

According to the present invention, the examiner is assisted in judgingthe present or absence of abnormality in the examinee's eye based on thefundus tomographic image.

Additional objects and advantages of the invention are set forth in thedescription which follows, are obvious from the description, or may belearned by practicing the invention. The objects and advantages of theinvention may be realized and attained by the fundus observationapparatus in the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the presentinvention and, together with the description, serve to explain theobjects, advantages and principles of the invention, In the drawings,

FIG. 1 is a block diagram for explaining the configuration of a fundusobservation apparatus according to a preferred embodiment of the presentinvention;

FIG. 2 is a view showing a case where a cross-line scan in horizontaland vertical directions is selected in a macula portion photographingmode;

FIG. 3 is a view showing a case where a horizontal line scan or a circlescan is selected in a papilla portion photographing mode;

FIG. 4 is a view showing a case where multi line photographing isperformed;

FIGS. 5A to 5D are views showing specific examples of a determinationcriterion for analyzing an image obtained in the macula portionphotographing mode;

FIGS. 6A and 6B are views showing specific examples of a determinationcriterion for performing thickness determination on a retinal opticnerve fiber layer (NFL);

FIGS. 7A and 7B are views showing specific examples of a determinationcriterion for analyzing an image obtained in the papilla portionphotographing mode;

FIGS. 8A and 8B are views showing specific examples of a determinationcriterion for determining a papilla portion image obtained by the circlescan;

FIG. 9 is a view showing a specific example of a determination criterionfor analyzing a front image; and

FIGS. 10A to 10C are views for explaining adjustment of an image pickupposition based on wide range tomographic image analysis.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

A detailed description of one preferred embodiment of a fundusobservation apparatus embodied by the present invention is providedbelow with reference to the accompanying drawings. FIG. 1 is a blockdiagram for explaining the configuration of the fundus observationapparatus according to the preferred embodiment of the presentinvention.

A fundus observation apparatus 1 is arranged to observe on a monitor afundus image obtained by a fundus photographing apparatus 10. The fundusobservation apparatus 1 includes a CPU (arithmetic control unit) 70, amouse (operation input unit) 76, a memory (storage unit) 72, and amonitor 75. These units are connected electrically to the CPU 70 viabuses or other mechanisms.

The CPU 70 controls operations of these units under an ophthalmicobservation program and various control programs that are stored in thememory 72. By executing the ophthalmic observation program on thecomputer, the fundus observation apparatus 1 becomes operational. TheCPU 70 controls the display screen on the monitor 75 following theophthalmic observation program. The ophthalmic observation programaccording to the preferred embodiment of the present invention has thefunction of displaying photographed images and various measurementresults on the monitor 75, and an analysis mode function of determiningwhether a photographed portion is normal or abnormal by analyzing atomographic image.

It is also preferable that an arithmetic processing unit, an input unit,a storage unit, and a display unit that are included in a commerciallyavailable PC (personal computer) are used for the CPU 70, the mouse 76,the memory 72, and the monitor 75, and the ophthalmic observationprogram is installed on the commercially available PC.

The fundus photographing apparatus 10 arranged to photograph an image ofa given portion of an examinee's eye is connected to the fundusobservation apparatus 1. As shown in FIG. 1, the fundus photographingapparatus 10 includes an interference optical system (OCT opticalsystem) 200 arranged to obtain a tomographic image of a fundus of theexaminee's eye, a front observation optical system 300 arranged toobtain a front image of the fundus, a control unit 400, and a fixationtarget projection unit 500 capable of fixating the examinee's eye andchanging the fixation direction. Thus, the fundus photographingapparatus 10 can photograph a fundus portion of the examinee's eye. Fora detailed configuration of the fundus photographing apparatus 10,please to refer to Japanese Patent Application Laid-open Publication No.2008-29467.

The fundus photographing apparatus 10 is arranged to select a givenregion of the fundus observation image (SLO image) obtained by pickingup an image of the fundus, and obtain a fundus tomographic image of theselected region using fundus OCT.

The interference optical system 200 includes a first scanning unit(optical scanner) arranged to scan first measurement light emitted froma first light source on the fundus, and a first photodetector arrangedto photo-receive interference light that is obtained by combiningreference light resulting from light emitted from the first light sourceand reflection light of the first measurement light that is projectedonto the fundus. Accordingly, the interference optical system 200 hasthe configuration of a so-called ophthalmic optical coherence tomography(OCT) device. For the configuration of the interference optical system200, Spectral-domain OCT (SD-OCT) using a spectrometer, Swept-source OCT(SS-OCT) using a wavelength variable light source, or Time-domain OCT(TD-OCT) may be used.

The front observation optical system 300 includes a second scanning unit(optical scanner) arranged to scan second measurement light (e.g.,infrared light) emitted from a second light source two-dimensionally onthe fundus, and a second photodetector arranged to photo-receive thelight reflected from the fundus through a confocal opening disposed at aposition substantially conjugate with the fundus. Accordingly, the frontobservation optical system 300 has the configuration of a so-calledophthalmic scanning laser ophthalmoscope (SLO). For the configuration ofthe front observation optical system 300, a so-called fundus camera typeconfiguration may be used.

The control unit 400 controls the members of the fundus photographingapparatus 10 to obtain the tomographic image (OCT image) based on aphoto-receiving signal outputted from the first photodetector of theinterference optical system 200 and obtain the front image (SLO image)based on a photo-receiving signal outputted from the secondphotodetector of the front observation optical system 300.

The fixation target projection unit 500 includes a visible light sourcethat emits visible light, and is arranged to change the photographedportion by two-dimensionally changing the fixation position of theexaminee's eye. The fixation target projection unit 500 may have variousconfigurations such as a configuration that the fixation position isadjusted by using the lighting position of LEDs arranged in a matrix anda configuration that light emitted from a light source is scanned by anoptical scanner and the fixation position is adjusted by controllinglighting of the light source.

The fundus observation apparatus 1 and the fundus photographingapparatus 10 are connected to each other on a LAN or other mechanisms,and signals are sent and received therebetween. Various data obtained inthe fundus photographing apparatus 10 (e.g., tomographic image data,front image data, various photographing conditions for image obtainment(e.g., image pickup information, selected region information, test dateand time)) are transferred to the memory 72 that is a database. Thecontrol unit 400 of the fundus photographing apparatus 10 controls theinterference optical system 200, the front observation optical system300, and the fixation target projection unit 500 based on operationsignals outputted from the mouse 76.

Descriptions of the operations of the apparatuses having theconfigurations described above are provided. First, the tomographicimage is obtained by using the fundus photographing apparatus 10. As apreliminary preparation to the image obtainment, patient information(e.g., ID number, name, age, sex, major complaint, comments) isinputted. On the monitor 75, the tomographic image obtained by theinterference optical system 200, the front image obtained by the frontobservation optical system 300, and a setting screen for setting thevarious photographing conditions are displayed.

When an image pickup portion is selected, the control unit 400 controlsthe fixation target projection unit 500 to move the fixation position toa position corresponding to the selected image pickup portion. Forexample, when a macula portion photographing mode is selected, thefixation position is set at the center, and when a papilla portionphotographing mode is selected, the fixation position is set toward thenose on a slightly upper side. It should be noted that the fixationpositions of right and left eyes are substantially symmetrical along thehorizontal direction. In the preferred embodiment of the presentinvention, a targeted image pickup portion and the fixation positionprovided by the fixation target photographing unit are associated witheach other, based on which the fixation position is set. Accordingly, atomographic image of a fundus portion the examiner desires is easilyobtained.

Then, a scanning pattern of the measurement light (e.g., line,cross-line, raster, circle, radial) is selected. For example, in themacula portion photographing mode, a cross-line scan in the horizontaland vertical directions is selected (see FIG. 2), and in the papillaportion photographing mode, a horizontal line scan or a circle scan isselected (see FIG. 3). Alternatively, multi line photographing shown inFIG. 4 may be performed.

Then, alignment and focusing with respect to the fundus are performedusing the front image obtained by the front observation optical system300. When a trigger of photographing is outputted, the control unit 400drives the first scanning unit based on the previously set photographingconditions to obtain a tomographic image corresponding to the selectedscanning pattern. The obtained tomographic image and the correspondingfront image (SLO image), image pickup information (e.g., fixationposition information, image pickup portion information, right and lefteye information), and selected region information (e.g., scanningpattern, scanning position, scanning range) are stored in the memory 72.The image pickup information described above may be information when thefront image corresponding to the tomographic image is obtained.

Then, the tomographic image and the front image that are obtained asdescribed above are observed by using the fundus observation apparatus1. When an analysis mode is selected, the CPU 70 detects information onretinal layers in the tomographic image stored in the memory 72 throughimage processing. Then, the CPU 70 analyses the detection result of theretinal layers by a given determination criterion, and determineswhether the photographed portion is normal or abnormal. Then, the CPU 70controls the monitor 75 to display the tomographic image and thedetermination result.

The determination result may be used as assisting information forassisting the examiner in judging the fundus tomographic image. In sucha case, the CPU 70 changes the determination criterion based on at leastone of the image pickup information and the selected region informationon the fundus tomographic image, and controls the monitor 75 to displaythe determination result obtained by the changed determination criterionas the assisting information. In other words, the CPU 70 changesinformation that is to be displayed as the assisting information basedon at least one of the image pickup information and the selected regioninformation on the fundus tomographic image.

The detection of the retinal layers is performed such that the CPU 70analyzes a brightness level of the tomographic image and detects aregion corresponding to a given retinal layer (e.g., retinal surface,retinal pigment epithelium layer). In addition, the determination of thephotographed portion may include thickness determination of the retinallayers, shape determination, and size determination of the givenportion. In addition, a database that stores thicknesses of retinallayers, shapes of given portions, sizes of the give portions of a normaleye may be used as the standard for the image determination criterion.

FIGS. 5A to 5D are views showing specific examples of a determinationcriterion for analyzing an image obtained in the macula portionphotographing mode. In an image of a macula portion, a characteristicimage of the retinal surface having a recessed portion at the center isgenerally obtained. The CPU 70 selects the determination criterion fordetermining the macula portion based on photographing mode information,and determines the detection result on the retinal layers by thedetermination criterion.

In the determination of the macula portion image, the CPU 70 determinesthat the photographed portion is normal if the thickness between theretinal layers is within a given range and the retinal layer shape isnormal (see FIG. 5A), and controls the monitor 75 to display thedetermination result. It should be noted that if the photographedportion is normal, the display is not necessarily performed.

On the other hand, the CPU 70 determines that the photographed portionis abnormal if the retinal layer shape is unusual (for example, therecessed portion is not detected (see FIG. 5B), the retinal layer has anirregular shape (see FIG. 5C)), if the thickness between the retinallayers is out of the given range (see FIG. 5D), or if the retinal layersare not detected, and controls the monitor 75 to display thedetermination result. For example, a message “the macula portion isabnormal” is displayed. In addition, the CPU 70 may highlight a portioncorresponding to the abnormal portion (for example, an image regioncorresponding to the macula portion is circled). The reason of thedetermination that the photographed portion is abnormal, for example,the recessed portion cannot be detected, may be displayed.

The CPU 70 may change the determination criterion according to thescanning direction of the measurement light on the fundus, and determinewhether the photographed portion is normal or abnormal by thedetermination criterion. This operation may be used when tomographicimages of the same portion (e.g., the macula portion) are obtained indifferent scanning directions.

For example, this operation may be used when the layer thicknessdetermination is performed on a retinal optic nerve fiber layer (NFL).In the case of determining a vertical line scan image obtained byscanning the measurement light in the vertical (up and down) direction(see FIG. 6A), the CPU 70 determines that the photographed portion isabnormal if, on the image, at least one of thicknesses of the nervefiber layer that is symmetrically formed on the right side and the leftside with respect to the macula portion are out of a given range (alsoif at least one of the thicknesses are not detected). The CPU 70determines that the photographed portion is normal if both of thethicknesses of the nerve fiber layer that is symmetrically formed on theright side and the left side with respect to the macula portion are inthe given range.

In the case of determining a horizontal line scan image obtained byscanning the measurement light in the horizontal direction (FIG. 6B),the CPU 70 determines that the photographed portion is abnormal if, onthe image, the thickness of the nerve fiber layer on the papilla portionside with respect to the macula portion (the right side in a right eyeand the left side in a left eye) is out of the given range (also if thethickness is not detected). The CPU 70 determines that the photographedportion is normal if the thickness is within the given range. It shouldbe noted that the CPU 70 does not determine that the photographedportion is abnormal even if the thickness of the nerve fiber layer onthe opposite side to the papilla portion with respect to the maculaportion is out of the given range (also if the thickness is notdetected). In the thickness determination of the nerve fiber layer, theuse of the horizontal line scan image may be avoided.

The change of the determination criterion according to the scanningdirection and the display of the determination results that thephotographed portion is normal or abnormal favorably assist anunaccustomed examiner in performing image diagnosis. The pattern of thenerve fiber layer extending in the retina is symmetric with respect tothe macula portion in the vertical direction and is asymmetric withrespect to the macula portion in the horizontal direction. Thus, anunaccustomed examiner could judge that the photographed portion isabnormal in a horizontal line scan image in which an image regioncorresponding to the nerve fiber layer is not visually observed in bothof right and left regions. However, the technique described above canprevent the examiner from making such a judgment error.

The present invention is not limited to the scanning patterns describedabove. It is also preferable that tomographic images that are obtainedat given angles (e.g., 30 degrees, 45 degrees) having a givenphotographed portion at the center are analyzed by differentdetermination criteria. In this case, because the extending pattern ofthe nerve fiber layer differs according to the scanning direction, theimage diagnosis is performed in consideration of this point.

In addition to the determination results, the CPU 70 may control themonitor 75 to display assisting information for assisting the examinerin performing the image diagnosis. In addition, the CPU 70 may controlthe monitor 75 to display different assisting information according tothe scan direction of the measurement light.

For example, in the case of displaying the vertical line scan image (seeFIG. 6A), the CPU 70 controls the monitor 75 to display a message “ifthe eye is normal, the nerve fiber layer is symmetric with respect tothe macula portion”, or to perform highlight display in the imagedisplay. In the case of displaying the horizontal line scan image (seeFIG. 6B), the CPU 70 controls the monitor 75 to display a message “evenif the eye is normal, the optical fiber layer is asymmetric with respectto the macula portion”, or to perform highlight display in the imagedisplay.

FIGS. 7A and 7B are views showing specific examples of a determinationcriterion for analyzing an image obtained in the papilla portionphotographing mode. In an image of a papilla portion, a characteristicimage of the papilla portion having a recessed portion at the centerthat is larger than the macula portion is obtained by the line scan. TheCPU 70 selects the determination criterion for determining the papillaportion based on the photographing mode information and the scanningpattern information, and determines the detection result on the retinallayers by the determination criterion. In other words, the CPU 70changes the determination criterion according to the scanning pattern.

In the determination of a papilla portion image obtained by the linescan, the CPU 70 determines that the photographed portion is normal ifthe size of the recessed portion (or a C/D ratio of the recessedportion) is within a given range (see FIG. 7A), and controls the monitor75 to display the determination result. The CPU 70 determines that thephotographed portion is abnormal if the size of the recessed portion isout of the given range (see FIG. 7B), and controls the monitor 75 todisplay the determination result. For example, a message “the papillaportion is abnormal” is displayed. The CPU 70 may determine whether thethickness between or the shape of the retinal layers is normal orabnormal as in the case of the macula portion.

In the determination of a papilla portion image obtained by the circlescan, the CPU 70 determines that the photographed portion is normal ifthe thickness of the nerve fiber layer is within a given range (see FIG.8A), and controls the monitor 75 to display the determination result.The CPU 70 determines that the photographed portion is abnormal if thethickness of the nerve fiber layer is out of the given range (see FIG.8B), and controls the monitor 75 to display the determination result.

As described above, whether the photographed portion is normal orabnormal can be properly determined by changing the determinationcriterion according to the image pickup portion information. Thus, anexaminer who lacks special knowledge about the image diagnosis based onthe tomographic image can easily judge whether the photographed portionis normal or abnormal based on the tomographic image.

By performing the line scan or the raster scan at a plurality ofdifferent positions on the fundus and obtaining a plurality oftomographic images by the fundus photographing apparatus 10, a widerange tomographic image is obtained. The CPU 70 may specify an image (ora plurality of images) including a characteristic portion from among theobtained plurality of images, and perform the image determinationdescribed above.

For example, the control unit 400 controls the driving of the firstscanning unit to perform the multi line scan (or the raster scan) withina given region A1 as shown in FIG. 4. Thus, a plurality of tomographicimages including the macula portion are obtained. The obtained pluralityof tomographic images are stored in the memory 72 and are observed bythe fundus observation apparatus 1.

The CPU 70 detects the sizes of the recessed portions in the tomographicimages, selects one (or more) of the tomographic images in which therecessed portion is largest as an image for the analysis based on thedetection result, and shifts to the analysis described above. Then, theCPU 70 determines whether the photographed portion is normal orabnormal. With this technique, the position of the photographed portionis accurately specified even if the position of a targeted image pickupportion is different among individuals, which allows the examiner toperform the image diagnosis adequately.

The present invention is not limited to the technique described above.The CPU 70 may analyze each of the plurality of tomographic images,perform the determination of the presence or absence of the abnormalportion and the specification of the position of the abnormal portionthrough image processing, and control the monitor 75 to display theresults.

In the configuration described above, the CPU 70 may determine theabnormal portion by analyzing the front image obtained by the frontobservation optical system 300. FIG. 9 is a view showing a specificexample of a determination criterion for analyzing the front image. Inthe front image, the abnormal portion appears as a brightness change(bright and dark) that does not appear in a normal eye (see a region A2in FIG. 9).

The CPU 70 selects a determination criterion for determining the frontimage and performs determination of the presence or absence of thebrightness change by the determination criterion. For example, in thedetermination of the front image, the CPU 70 detects a portion having abrightness level lower than a given level or a portion having abrightness level higher than the given level through image processing,and performs the determination of the presence or absence of theabnormal portion and the specification of the position of the abnormalportion.

Adjustment of Image Pickup Position Based on Tomographic Image Analysis

The fundus photographing apparatus 1 may obtain a tomographic image of adesired portion by performing the analysis described above. For example,the control unit 400 may analyze the tomographic image obtained by theinterference optical system 200, specify a targeted image pickup portionthrough image processing, and adjust the image pickup position so as toobtain an image of the targeted image pickup portion.

In this case, the control unit 400 successively obtains and analyses thetomographic images while adjusting the scanning position of the firstscanning unit (an oscillation angle, the center position of theoscillation angle) in order that the scanning position of themeasurement light on the fundus may correspond to the position at whicha characteristic image (e.g., an image having a characteristic shape asthe image pickup portion) is obtained.

For example, the control unit 400 controls the driving of the firstscanning unit to perform the multi line scan or the raster scan. Then,the control unit 400 adjusts the image pickup position so as to obtainthe tomographic image having the recessed portion corresponding to themacula portion at the center. In this case, the control unit 400 detectsthe sizes of the recessed portions in the successively obtainedtomographic images. If the control unit 400 determines that thetomographic image having the recessed portion corresponding to themacula portion is obtained based on the detection result, the controlunit 400 fixes the scanning position of the measurement light. Then, thecontrol unit 400 successively obtains the tomographic images at thescanning position and outputs the images as a moving image.

In the configuration described above, the control unit 400 performs thedetermination whether the photographed portion is normal or abnormal andthe specification of the position of the abnormal portion through imageprocessing while successively obtaining and analyzing the tomographicimages. The control unit 400 may control the driving of the firstscanning unit to obtain the tomographic image of the abnormal portion.

Screening Using Wide Range Tomographic Image and Obtainment ofTomographic Image of Abnormal Portion

FIGS. 10A to 10C are views for explaining adjustment of the image pickupposition based on wide range tomographic image analysis. For example,the control unit 400 controls the driving of the first scanning unit toscan the measurement light two-dimensionally in a wide range of thefundus and obtain a wide range tomographic image of the fundus (a firsttomographic image) (see a hatched portion S1 in FIG. 10A, for example).In this case, it is preferable that the scanning range is set such thatthe macula portion and the papilla portion are included in thephotographing range (e.g., a rectangular region 9 mm long and 9 mm wide,a rectangular region 12 mm long and 12 mm wide). For the scanningpattern, the multi line scan or the raster scan is used, for example.Thus, a plurality of tomographic images that provide fundus tomographicinformation in the wide range can be obtained.

Next, the control unit 400 specifies the abnormal portion by analyzingthe obtained first tomographic image through image processing (firstanalysis). The control unit 400 may perform analysis appropriate to eachof the retinal portions in the tomographic image or may analyze thewhole first tomographic image by one criterion (details are providedlater).

The control unit 400 outputs the obtained first tomographic image andthe front image that is obtained substantially concurrently with thefirst tomographic image on the monitor 75, and outputs a result of thefirst analysis on the monitor 75. The control unit 400 may successivelydrive the interference optical system 200 and the front observationoptical system 300 and control the monitor 75 to display a graphicshowing the analysis result (for example, display a mark at a portioncorresponding to the abnormal portion) in the state of beingsuperimposed on the tomographic observation images and the frontobservation image that are obtained in real time as moving images (see amark ER in FIG. 10B). Thus, the examiner is allowed to check theabnormal portion based on the observation images during examination.

Next, the control unit 400 sets a region that is specified to be theabnormal portion as a scanning range of the measurement light andcontrols the driving of the first scanning unit to obtain a secondtomographic image (see a hatched portion S2 in FIG. 10C). The controlunit 400 may set the scanning range by obtaining the scanning positioncorresponding to the region that is specified to be the abnormal portion(the driving position of the first scanning unit) based on the relationbetween the first tomographic image and the scanning position.

In the case of obtaining the second tomographic image, it is preferableto use the scanning pattern that is suitable for the image obtainment ofthe abnormal portion. In addition, it is preferable that the scanningrange of the second tomographic image is narrower than the scanningrange of the first tomographic image (the wide range tomographic image)of the fundus and includes the whole abnormal portion. For example, theraster scan is performed on a rectangular region that is adjusted to thesize of the abnormal portion. In addition, the fixation position ispreferably set at a position that is suitable for the image obtainmentof the abnormal portion. It is also preferable that a plurality oftomographic images are obtained at the same abnormal portion and anaveraged image thereof is obtained.

In the case of obtaining the second tomographic image, the control unit400 may automatically shift to the obtainment of the second tomographicimage based on the analysis result of the first tomographic image, ormay start the obtainment of the second tomographic image using anoperation signal from the mouse 76 as a trigger.

If a plurality of abnormal portions are detected, the control unit 400obtains the second tomographic image in a scanning range that isnarrower than the scanning range of the wide range tomographic image andincludes the plurality of abnormal portions. In addition, the controlunit 400 may set scanning ranges for the abnormal portions and obtaintomographic images of the abnormal portions successively.

Analysis Appropriate to Each of Retinal Portions

In the case of performing analysis appropriate to each of the retinalportions, the control unit 400 specifies regions corresponding to themacula portion and the papilla portion in the obtained tomographicimages through image processing. Then, the control unit 400 performsanalysis appropriate to each of the specified regions. When the maculaportion is specified, the control unit 400 analyses the macula portionin the tomographic images by using the analysis technique used in themacula portion photographing mode described above. If the papillaportion is specified, the control unit 400 analyses the papilla portionin the tomographic images by using the analysis technique used in thepapilla portion photographing mode described above.

In the case of specifying the given portion in the tomographic image,the macula portion and the papilla portion can be extracted based onpositions, brightness values, and shapes in the tomographic image. Forthe macula portion that has brightness lower than that of its peripheralportion and has a circular shape, image processing is performed so as toextract an image region that shows these properties. For the papillaportion that has brightness higher than that of its peripheral portionand has a circular shape, image processing is performed so as to extractan image region that shows these properties. It is also preferable thatthe positions of the macula portion and the papilla portion arespecified by using the front image, and the results are used for theanalysis of the tomographic image.

For example, if the CPU 70 determines that the papilla portion isabnormal, the control unit 400 sets the papilla portion as the scanningrange of the measurement light and controls the driving of the firstscanning unit to obtain the tomographic image of the papilla portion.The scanning range is set to be narrower than the scanning range of thewide range tomographic image described above and to include the wholepapilla (for example, 4.5 mm long and 4.5 mm wide). For the papillaportion, the circle scan or the radial scan may be performed.

Analysis on Whole Fundus

In the case of analyzing the whole tomographic images by one criterion,the control unit 400 calculates the thicknesses of the retinal layers(e.g., retinal surface layer, retinal pigment epithelium layer) in thetomographic images. The control unit 400 two-dimensionally obtains aposition at which the thickness is out of the given range. A result ofcomparison between the layer thicknesses of the examinee's eye and layerthicknesses of a normal eye with respect to the horizontal and verticaldirections may be used. In addition, the sum of the layer thicknessesmay be used in the layer thickness analysis.

The control unit 400 sets the abnormal portion as the scanning range ofthe measurement light, and controls the driving of the first scanningunit to obtain the tomographic image of the abnormal portion. Thescanning pattern that is suitable for the image obtainment of theabnormal portion is preferably used.

With the configuration described above, the two-dimensional tomographicimage obtained in the wide scanning range is analyzed, and the abnormalportion in the whole fundus is specified, so that the tomographic imagecan be obtained with the photographing conditions suitable for theabnormal portion. Because the scanning range is narrower than the widescanning range and includes the whole fundus, deviation between theimages is minimized, and the tomographic image of the abnormal portioncan be obtained with high resolution.

The control unit 400 analyzes the second tomographic image (secondanalysis) and outputs the analysis result on the monitor 75. Thus, aprecise analysis result of the abnormal portion is obtained. In thiscase, the specification and the analysis of the abnormal portion on thefundus can be smoothly performed by specifying the abnormal portionthrough screening on the whole fundus and precisely analyzing theabnormal portion.

The control unit 400 outputs the second tomographic image and the frontimage that is obtained substantially concurrently with the secondtomographic image on the monitor 75, and outputs the result of thesecond analysis on the monitor 75. In addition, the control unit 400outputs the first tomographic image and the second tomographic image onthe monitor 75. At least one of the first tomographic image and thesecond tomographic image may be displayed in the form of athree-dimensional tomographic image.

Correction of Positional Deviation Between First Tomographic Image andSecond Tomographic Image

In the configuration described above, the control unit 400 may correctthe image pickup position of the tomographic image by obtaining thefundus front image that is obtained concurrently with the firsttomographic image and calculating a positional deviation between theabove fundus front image and the fundus front image that is obtainedconcurrently with the second tomographic image. The front image may bean image that is obtained by using data forming a two-dimensionallyobtained tomographic image (e.g., an integrated image of tomographicimages in the depth direction, an integrated value of spectral data atpositions in the horizontal and vertical directions).

In addition, the control unit 400 may perform matching between thetomographic image corresponding to the abnormal portion in the firsttomographic image and the tomographic images that are continuallyobtained when obtaining the second tomographic image through imageprocessing, and correct the scanning position so as to obtain thetomographic image at a substantially matching position (the front imagemay be used instead of the tomographic image). For example, the image ofthe abnormal portion in the first tomographic image is set as a templateimage, and template matching is performed between the tomographic imagescontinually obtained and the template image. The scanning position isadjusted so that a correlation may become highest.

Screening Using Wide Range Tomographic Image and Obtainment ofTomographic Image of Characteristic Portion

The above descriptions have been given on the case where the tomographicimage of the abnormal portion is obtained. However, it is essential onlythat a tomographic image of a given portion in a wide range tomographicimage be obtained by a screening scan.

For example, the control unit 400 may specify a characteristic portion(e.g., papilla portion, macula portion) by analyzing the obtained firsttomographic image through image processing, and adjust the image pickupposition so as to obtain a tomographic image of the specifiedcharacteristic portion. As for the technique of specifying the givenportion in the tomographic image, please refer to “ANALYSIS APPROPRIATETO EACH OF RETINAL PORTIONS” provided above.

Selective Storing of Tomographic Images

The control unit 400 may control the driving of the first scanning unitto perform the multi line scan or the raster scan, and store only thetomographic images that do not meet the given image determinationcriterion and are determined to be abnormal in the memory 72.

Adjustment of Image Pickup Position Based on Front Image Analysis

The control unit 400 may analyze the front image obtained by the frontobservation optical system 300, perform the determination of thepresence or absence of the abnormal portion and the specification of theposition of the abnormal portion, and adjust the image pickup positionby the interference optical system 200 so as to obtain the tomographicimage of the abnormal portion. The technique of the determination is thesame as that of the front image analysis, and descriptions thereof areomitted. Accuracy in specifying the abnormal portion is improved byspecifying the abnormal portion based on both of the analysis result onthe tomographic image and the analysis result on the front image, andadjusting the image pickup position.

When the abnormal portion is specified, the control unit 400 obtains thetomographic image by controlling the driving of the first scanning unitin order that the scanning position of the measurement light on thefundus may correspond to the abnormal portion (e.g., the portion A2 inFIG. 9).

When the scan is performed on the abnormal portion, the control unit 400may control the fixation target projection unit 500 with the drivingposition of the optical scanner being fixed, and guide a line of sightof the examinee's eye by moving the fixation position.

When the image obtainment, the analysis, and the determination arefinished, the obtained images, the analysis results, and thephotographing conditions (the image pickup information, the selectedrange information) are stored in association with the patientinformation. This information can be used as information for performingalignment with respect to the same portion at the time ofre-photographing. In other words, the CPU 70 controls the memory 72 tostore the photographing conditions including the fixation position(photographed portion) and the image pickup position (scanning position)in association with the photographed images, and reconstitute thephotographing conditions at the time of re-photographing.

The alignment may be performed using the shape in the stored retinallayer detection result as a characteristic. In this case, the controlunit 400 detects the shape in the tomographic image stored in the memory72 and successively analyzes tomographic images obtained by theinterference optical system 200. The control unit 400 may control thedriving of the first scanning unit based on the analysis result and thedetection result, and adjust the image pickup position so as to obtaintomographic images of the same portion that has the shape in thedetection result.

In the above configuration, the analysis is performed using thetwo-dimensional tomographic image. However, the present invention is notlimited thereto. The analysis may be performed using a three-dimensionalimage. In this case, determination whether a three-dimensional shapeinclude a characteristic shape or not is performed.

The foregoing description of the preferred embodiments of the inventionhas been presented for purposes of illustration and description. It isnot intended to be exhaustive or to limit the invention to the preciseform disclosed, and modifications and variations are possible in thelight of the above teachings or may be acquired from practice of theinvention. The embodiments chosen and described in order to explain theprinciples of the invention and its practical application to enable oneskilled in the art to utilize the invention in various embodiments andwith various modifications as are suited to the particular usecontemplated. It is intended that the scope of the invention be definedby the claims appended hereto, and their equivalents.

What is claimed is:
 1. A fundus observation apparatus comprising: anoptical coherence tomography device that has an optical scanner forsetting an configured to set image pickup position positions on a fundusof an examinee's eye, and is arranged eye and to obtain a tomographicimage of the fundus according to any one of a plurality of photographingmodes, each mode corresponding to a distinct image pickup position ofthe image pickup positions; an information display unit that is arrangedto display on a monitora display that displays the tomographic imageobtained by the optical coherence tomography device and assistinginformation for assisting an examiner in performing judgment on thetomographic image; and a front fundus image pickup device configured toobtain a front image of the fundus; a first non-transitory computerreadable medium storing a first program for use with a processor, thefirst program causing the processor to execute steps comprising:receiving an instruction signal by the examiner to select onephotographing mode among the plurality of photographing modes, anarithmetic analysis unit that is arranged to detectdetecting informationon layers of the fundus in the tomographic image through imageprocessing, and determines the tomographic image by determininganalyzing the detected layer information by a given determinationcriterion, in the tomographic image and performing a judgment as towhether the tomographic image satisfies a determination criterion,changing the determination criterion depending on the selectedphotographing mode, changing the assisting information based on theselected photographing mode and the display displays a firstdetermination result as the assisting information, detecting brightnessinformation on the front image obtained by the front fundus image pickupdevice through the image processing, and determining the front image bydetermining the detected brightness information by the determinationcriterion; and a second non-transitory computer readable medium storinga second program for use with a controller, the second program causingthe controller to execute a steps comprising: controlling driving of theoptical scanner to change the image pickup position on the fundus basedon the photographing mode that is selected by the instruction signal,wherein the information display unit is arranged to change the assistinginformation based on image pickup information on the tomographic image;the arithmetic analysis unit is arranged to change the determinationcriterion based on at least the image pickup information; and theinformation display unit is arranged to display a first determinationresult obtained by the arithmetic analysis unit as the assistinginformation on the monitor controlling a fixation position depending onthe photographing mode in controlling the driving of the opticalcoherence tomography device depending on the photographing mode, andemitting visible light toward the examinee's eye and guiding a line ofsight of the examinee's eye by adjusting the position at which thevisible light is projected on the fundus such that, when the opticalcoherence tomography device is in macula portion photographing mode, thefixation position is moved to a position corresponding to a position ofthe macula, and, when the optical coherence tomography device is inpapilla portion photographing mode, the fixation position is moved to aposition corresponding to a position of the papilla.
 2. The fundusobservation apparatus according to claim 1, wherein the arithmeticanalysis unit uses performing the judgment as to whether the tomographicimage satisfies the determination criterion includes using a normal eyedatabase as the determination criterion.
 3. The fundus observationapparatus according to claim 1, further comprising: a control unit thatis arranged to control driving of the optical scanner to change theimage pickup position on the fundus, wherein the arithmetic analysisunit is arranged to specify the first program further causes theprocessor to execute specifying an abnormal portion in the tomographicimage based on the first determination result or specify specifying acharacteristic portion in the tomographic image through the imageprocessing, and the control unit is arranged to adjust second programfurther causes the controller to execute adjusting the image pickupposition so as to obtain the tomographic image including one of theabnormal portion and the characteristic portion that are specified bythe arithmetic analysis unit.
 4. The fundus observation apparatusaccording to claim 3, wherein the control unit is arranged to obtainsecond program further causes the controller to execute obtaining afirst tomographic image of a wide range of the fundus bytwo-dimensionally scanning measurement light on the fundus using theoptical scanner, the arithmetic analysis unit is arranged to specifythefirst program further causes the processor to execute specifying one ofthe abnormal portion and the characteristic portion in the firsttomographic image, and the control unit is arranged to obtain secondprogram further causes the controller to execute obtaining a secondtomographic image by scanning the measurement light in a scanning rangecorresponding to the portion specified by the arithmetic analysis unitspecified portion.
 5. The fundus observation apparatus according toclaim 4, wherein the arithmetic analysis unit is arranged to determinefirst program further causes the processor to execute determining thesecond tomographic image and obtain obtaining a second determinationresult, and the information display unit is arranged to display displaysthe first and second tomographic images and the first and seconddetermination results that are obtained by the arithmetic analysis unit.6. The fundus observation apparatus according to claim 4, wherein thecontrol unit is arranged to set second program further causes thecontroller to execute setting the scanning range for obtaining thesecond tomographic image to be a scanning range that is narrower thanthe scanning range for obtaining the first tomographic image andincludes the whole specified portion.
 7. The fundus observationapparatus according to claim 4, wherein the control unit is arranged toset second program further causes the controller to execute setting ascanning pattern of the measurement light according to the specifiedportion.
 8. The fundus observation apparatus according to claim 4,wherein the arithmetic analysis unit is arranged to specify firstprogram further causes the processor to execute specifying a regioncorresponding to a the macula portion in the first tomographic imagethrough the image processing, and perform determination appropriate tothe specified region.
 9. The fundus observation apparatus according toclaim 4, wherein the arithmetic analysis unit is arranged to specifyfirst program further causes the processor to execute specifying aregion corresponding to a the papilla portion in the first tomographicimage through the image processing, and perform determinationappropriate to the specified region.
 10. The fundus observationapparatus according to claim 4, wherein the control unit is arranged toset second program further causes the controller to execute setting thescanning range for obtaining the second tomographic image by obtaining ascanning position of the optical scanner corresponding to the specifiedportion based on a relation between the first tomographic image and ascanning position of the optical scanner.
 11. The fundus observationapparatus according to claim 4, wherein the control unit is arranged toperform second program further causes the controller to executeperforming matching between a tomographic image corresponding to thespecified portion in the first tomographic image and a tomographic imageimages obtained when obtaining the second tomographic image through theimage processing, and correct correcting a scanning position of theoptical scanner so as to obtain a matching topographic image among thetomographic images obtained when obtaining the second tomographic imageat a substantially matching position.
 12. The fundus observationapparatus according to claim 1, further comprising: a front fundus imagepickup device that is arranged to obtain a front image of the fundus,wherein the arithmetic analysis unit is arranged to detect brightnessinformation on the front image obtained by the front fundus image pickupdevice through the image processing, and determine the front image bydetermining the detected brightness information by a given determinationcriterion.
 13. The fundus observation apparatus according to claim 12 1,wherein the arithmetic analysis unit is arranged to specify firstprogram further causes the processor to execute specifying one of atargeted image pickup portion and the abnormal portion based ondetermination results of the tomographic image and the front image thatare obtained by the arithmetic analysis unit through the imageprocessing, and the control unit is arranged to adjust second programfurther causes the controller to execute adjusting the image pickupposition so as to obtain the tomographic image including the specifiedportion.
 14. The fundus observation apparatus according to claim 1,wherein the plurality of photographing modes comprises a mode forphotographing both a macula portion and a papilla portion.
 15. Thefundus observation apparatus according to claim 1, wherein the secondprogram further causes the controller to execute controlling a scanningposition of the optical scanner depending on the photographing mode incontrolling the driving of the optical coherence tomography devicedepending on the photographing mode.
 16. The fundus observationapparatus according to claim 1, wherein the displayed assistinginformation includes the presence or absence of an abnormality in theimage pickup positions related to the photographing modes.